Let’s Talk About Feet- The Numb Foot

(From the 2010 Diabetes Today Edition)

By Simone McConnie, BSC Pod Med (UK)

Podiatrist in private practice, Barbados

As a rule we grow up knowing that when something hurts we know something is wrong.  But with diabetes this is not the case.  Numb feet are a complication of the diabetic foot.  The other complication addresses the loss of a good blood supply to the foot and the inability to heal very easily.  These are factors which compounded can lead to amputations for persons with diabetes.

In this article we address the importance of examining your feet on a daily basis in order to detect problems early enough to prevent troubles that can result in amputations. 

Amputations usually lead to a change of life practices, and a loss of independence for some individuals.

Unfortunately we as human beings do not always manage our lives and diseases proactively.  We are quick to respond with the initial onset of the disease and then we are slow to maintain that level of commitment to ensure prevention of problems.

Numb feet form one of the key pathways for ulcers to form at the bottom of the feet of persons with diabetes.  Most of the time there are other risk factors involved like poor circulation, poor healing and poor management of diabetes in general. However, having numb feet is the result of long term damage as a result of having diabetes.  The small nerve fibers of the feet that provide a feeling of touch, pain, ability to detect extreme cold or extreme hot conditions becomes damaged and we loose the ability to feel these things.

If we think of the fact that we have nerve fibers for different things it makes it easier to understand.  We have nerves for feeling, a different group of nerves for controlling the things we have no control over like the blinking of our eyes, perspiration (which provides a level of moisture to the skin) and the sudden reactions we do to protect ourselves, and then the nerves that control the ability to move or toes and feet wiggling etc.  These nerve fibers are different sizes.  Depending on the degree of damage you have will depend on the nerves that are affected.  The damage is directly related to the level of control you have on your diabetes.

Numb feet are medically known as neuropathy. 

These numb feet may initially present as feeling as though you are walking on cotton wool, persons also often complain of feeling like if there is something under their foot but when they check they see nothing; or they may also complain of burning and tingling in their feet.  This can then progress to walking with a high step and walking out of shoes that are not fitting appropriately.  They loose the ability to know whether they are wearing shoes or not is not uncommon.

Persons with neuropathy tend to get minor injuries from wearing shoes that are not fitting right, walking barefooted, or just stumping their toes.   They also tend to have a lot of calluses under their foot as this is the body’s first line of defense if there is a deformed area of the foot and excess pressures to that area.  If these calluses are not addressed early they lead to bruising under the skin and this leads to ulcers.

Just because you have numb feet does not mean you do not have poor circulation you can have both, one or none as a diabetic. 

Over the years as a Podiatrist in the UK and Barbados it is not uncommon to see persons with numb feet walking into the clinic with a tack stuck in their foot or a rub from a nail or screw in the shoe because of an ill fitting shoe.  If these are identified early it can prevent amputations.

Routine visits with your Podiatrist helps you to stay on top of the game as they are in a position to help identify areas of the feet that maybe at risk for callus to form and help you to have regular foot screens to monitor your level of feeling in your feet.

So the main tips to remember are:

Do examine your feet daily

Do check your shoes before putting them on daily

Do keep your diabetes under control

Do use creams on your feet to encourage less dryness of the feet.

Do not walk barefooted even on carpet

When you are unsure of anything seek attention as soon as possible from your Podiatrist.

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